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Individual

DR. MIA BURNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
1750 SAINT CHARLES AVE UNIT CU1, NEW ORLEANS, LA 70130-6732
(504) 609-9077
Mailing address
1750 SAINT CHARLES AVE UNIT CU1, NEW ORLEANS, LA 70130-6732
(504) 609-9077

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7040
LA
1223G0001X
General Practice Dentistry
G1-0001401
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7040
DENTAL LICENSE
LA
Enumeration date
04/20/2016
Last updated
01/05/2024
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